7+ Year Member

Ok , the situation is this: After the surgery the main surgeon refused to disclose identity of one member of surgical team who he brought under very suspecious circumstances. It is definately proved that another person was present and involved in surgery. Inspite of all this the main sirgeon refuses to disclose identity of that other physician. Can he get away with that? He did not leave any record about that other physician but it was proved in other way that another person was present and involved in surgery. It is believed that the other physician was not licenced to practice medicine. The medical board is investigating the case but there is significant delay. What do you think about this. The rule/law says if some doctor enables someone who is not licenced to be involved in surgery then that doctor's licence would be revoked. But, what would be the case if the main surgeon refuses to disclose identity of that other person that he enabled to participate in surgery???

10+ Year Member

Ok , the situation is this: After the surgery the main surgeon refused to disclose identity of one member of surgical team who he brought under very suspecious circumstances. It is definately proved that another person was present and involved in surgery. Inspite of all this the main sirgeon refuses to disclose identity of that other physician. Can he get away with that? He did not leave any record about that other physician but it was proved in other way that another person was present and involved in surgery. It is believed that the other physician was not licenced to practice medicine. The medical board is investigating the case but there is significant delay. What do you think about this. The rule/law says if some doctor enables someone who is not licenced to be involved in surgery then that doctor's licence would be revoked. But, what would be the case if the main surgeon refuses to disclose identity of that other person that he enabled to participate in surgery???

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I believe it was Professor Plum, in the library, with the candlestick.

The operating room records can be subpoeaned and the OR circulator should have noted the name of the presumed non-licensed physician who assisted in the OR.

Now there are rules about whom can scrub and assist in the OR and it does not have to be a licensed physician (we all know that medical students and RN-FAs scrub), but JCAHO does require the OR staff to document the presence of anyone scrubbed.

7+ Year Member

Dr. Cox,
The question is not how it should be, we all know that already. It is understandable that it wouldn't be a problem to find out who it was, but the issue is not trying to find out, the issue is that the main surgeon simply refuses to disclose identity of that person. For that matter, good question is if he can get away refusing to disclose it and if that behaviour can be acceptable?

Dr. Cox,
The question is not how it should be, we all know that already. It is understandable that it wouldn't be a problem to find out who it was, but the issue is not trying to find out, the issue is that the main surgeon simply refuses to disclose identity of that person. For that matter, good question is if he can get away refusing to disclose it and if that behaviour can be acceptable?

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You're right - I didn't address that question.

Obviously I'm not a lawyer but I suppose it would depend on to whom he is refusing to disclose that information. I don't suppose he HAS to tell anyone unless he is legally obligated by the courts; of course, if the "plantiff" (we're assuming the patient or their representative) is asking, suspecting that he had a non-licensed physician in the OR assisting/doing the case, and he refuses to disclose the name of that physician, while it might be understandable, it probably doesn't do him any good in the eyes of the law or for the goodwill of the patient.

I'm afraid the story really isn't clear to me. I mean, if the situation is as I described above, he doesn't HAVE to disclose the person's name as he is the surgeon of record and any liability should be directed toward him (ie, same as if the other surgeon was a resident or medical student).

However, if the person inquiring as to whom else was in the OR is another staff member, then I'm not sure why they would need to know. You also refer to a "rule/law" that says it is illegal for a surgeon to have someone non-licensed assist in the OR. He can't bill for a non-licensed physician or Nurse Assist, but I am not aware of any law that says that the assistant has to be a licensed physician or nurse.

Without more details, it would be hard to say but again, IMHO, as a non-lawyer, I don't think he is required at this point, without a court order, to divulge the name of any operating room personnel. It might make things easier for him to give the info to the Medical Board, but he obviously has reasons not to. Care to elaborate?

7+ Year Member

This is interesting, because I have found that sometimes I cant even walk in to the OR (in scrubs, mask, cap etc) to tell Dr. Whoever that his patients bowels are now flowing like crazy without getting interrogated about who I was, where was my ID badge, that it needed to be seen at all times in the OR .and get told this about about every other day .
Like, Its me the guy who was scrubbed in yesterday (or on an earlier case) who gave the other bowel and antibiotic report the day before the person whom you were bs-ing with the other night on call about how hot it is out.
Sometimes it feels like how Mr. Burns never knew who Homer was!

10+ Year Member

Just like last year, when you posted the same situation, I don't understand what you're asking.

Why don't you explain the situation more clearly?

How are you involved? Are you the attending surgeon? The mystery "member of the surgical team"? Just an observer in the OR?

Or did you just hear about this case from someone else? If so, why does this concern you?

How is it "proved" that the attending had an assistant? The nurses in the OR saw him/her? It's on the nurses' records? It's on the OR schedule?

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I thought it was this guy who scrubbed in with a family friend in like an optho case or something and there was an untoward event and now he was afraid he was going to get busted and lose his brand new residency position. i seem to recall something about canada too....but seriously..this intern year thing is slowly turning my brain to mush.

7+ Year Member

for Dr. Cox and Blade 28:
would you like me to send you some more details and questions via private messaging?

anyway, Dr Cox, I don't understand that you say the surgeon doesn't have to disclose name of person he brought and got involved in surgery. It means like he can bring anyone and let do anything without any responsibility. The role of that other person is not clear. There are lot of speculations about it, even possibility that some experimentation was done on patient. The surgeon is fighting so badly not to disclose identity of that other man. Trust me, you woudn't believe things happening. According to some top lawyers and even one judge the surgeon cannot get court order to disclose identity of that other person, which is very strange too. The good question is about current fight if he will disclose identity of that man to medical board or not.

for Dr. Cox and Blade 28:
would you like me to send you some more details and questions via private messaging?

anyway, Dr Cox, I don't understand that you say the surgeon doesn't have to disclose name of person he brought and got involved in surgery. It means like he can bring anyone and let do anything without any responsibility. The role of that other person is not clear. There are lot of speculations about it, even possibility that some experimentation was done on patient. The surgeon is fighting so badly not to disclose identity of that other man. Trust me, you woudn't believe things that are happening. According to some top lawyers and even one judge the surgeon cannot get court order to disclose identity of that other person, which is very strange too. The good question is about current fight if he will disclose identity of that man to medical board or not.

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I said he didn't have to disclose the name of the assistant without a court order. Is that the right thing to do? Probably not, but then again, it depends on whom is asking. The attending surgeon has a right to protect the identity of others whom might be involved in a lawsuit by proxy (ie, they aren't the main party against whom the complaint is lodged).

In no way did I mean to express that the act of not divulging the assistant's name means that the surgeon can "bring in anyone and let do anything without responsibility." That is simply not the case. The attending surgeon of record has a responsibility to provide an assistant with whom he feels comfortable. If the assistant is not highly skilled or qualified (ie, a 3rd year medical student), then the assistant should be only doing things within his skill range (holding retractors, opening the wound, some closing, perhaps some Bovieing), etc. and the surgeon should be doing most of the case.

However, from your earlier description it sounds as if the assistant was a non-licensed physician who did most of the case. I agree - that should not be allowed, but I cannot agree that the attending surgeon of record can be forced to divulge his identity. But then again, I'm not a lawyer, nor is anyone who has posted here, so I cannot comment on your statement that they cannot get a court order. Seems strange to me.

Since this is not a residency issue per se (at least as far as we can see), perhaps you might want to post it on the Everyone Forum and you might get some lawyer types to weigh in.

7+ Year Member

I said he didn't have to disclose the name of the assistant without a court order. Is that the right thing to do? Probably not, but then again, it depends on whom is asking. The attending surgeon has a right to protect the identity of others whom might be involved in a lawsuit by proxy (ie, they aren't the main party against whom the complaint is lodged).

In no way did I mean to express that the act of not divulging the assistant's name means that the surgeon can "bring in anyone and let do anything without responsibility." That is simply not the case. The attending surgeon of record has a responsibility to provide an assistant with whom he feels comfortable. If the assistant is not highly skilled or qualified (ie, a 3rd year medical student), then the assistant should be only doing things within his skill range (holding retractors, opening the wound, some closing, perhaps some Bovieing), etc. and the surgeon should be doing most of the case.

However, from your earlier description it sounds as if the assistant was a non-licensed physician who did most of the case. I agree - that should not be allowed, but I cannot agree that the attending surgeon of record can be forced to divulge his identity. But then again, I'm not a lawyer, nor is anyone who has posted here, so I cannot comment on your statement that they cannot get a court order. Seems strange to me.

Since this is not a residency issue per se (at least as far as we can see), perhaps you might want to post it on the Everyone Forum and you might get some lawyer types to weigh in.

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Dr. Cox,
I already wrote that role of that other man is not clear and that the case happened under very suspecious circumstances, but you still keep talking about assistant as you excluded possibility that the other person was doing anything else except assisting. The key thing is the issue if something illegal was done on patient and that's exactly the reason for disclosure of identity of that other person.

10+ Year Member

Just like last year, when you posted the same situation, I don't understand what you're asking.

Why don't you explain the situation more clearly?

How are you involved? Are you the attending surgeon? The mystery "member of the surgical team"? Just an observer in the OR?

Or did you just hear about this case from someone else? If so, why does this concern you?

How is it "proved" that the attending had an assistant? The nurses in the OR saw him/her? It's on the nurses' records? It's on the OR schedule?

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I think I saw this on an episode of law and order. There was some company rep showing the surgeons how to use this new machine in a case and the pt died.
OOH maybe someone woke up from anesthesia pregnant...I think that should be a law and order episode too.

Dr. Cox,
I already wrote that role of that other man is not clear and that the case happened under very suspecious circumstances, but you still keep talking about assistant as you excluded possibility that the other person was doing anything else except assisting. The key thing is the issue if something illegal was done on patient and that's exactly the reason for disclosure of identity of that other person.

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The problem is you have not been clear. Whether or not the man in question was an assistant, if the surgeon of record was there, anyone else is considered the "assistant" whether or not they did the case. Its really semantics - yes, I agree that if the man in question did the case technically he did not assist, but in the eyes of the OR record he did, and that's what the lawyers will focus on.

I understand that you feel that a non-licensed physician operated on a patient and that the surgeon of record refuses to disclose the name of the former. What we do not know is why this is important (was there a complication, is the patient sueing) and what role you play in this.

It is not clear whether when you say "something illegal" was done on the patient you are referring to having the non-licensed physician do the case while the surgeon of record stood by, or what. Frankly, I'm not sure its illegal. as he was not the surgeon of record (right?), so technically he was still "assisting".

7+ Year Member

The problem is you have not been clear. Whether or not the man in question was an assistant, if the surgeon of record was there, anyone else is considered the "assistant" whether or not they did the case. Its really semantics - yes, I agree that if the man in question did the case technically he did not assist, but in the eyes of the OR record he did, and that's what the lawyers will focus on.

I understand that you feel that a non-licensed physician operated on a patient and that the surgeon of record refuses to disclose the name of the former. What we do not know is why this is important (was there a complication, is the patient sueing) and what role you play in this.

It is not clear whether when you say "something illegal" was done on the patient you are referring to having the non-licensed physician do the case while the surgeon of record stood by, or what. Frankly, I'm not sure its illegal. as he was not the surgeon of record (right?), so technically he was still "assisting".

Whatever. My brain is getting tired from trying to figure this out.

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Dr. Cox,
thank you for your reply. The issue is that there are some indications that it was done something illegal that does not have anything to do with the surgery performed. That's what patient and some people believe. By "something illegal" is not meant only if that other person was enough qualified or licenced, but rather what was done on patient and if it is done something along the surgery performed that does not have anything to do with the surgery (some kind of experiment). As there are some evidence and indications suggesting that, for that matter, it would be very important to disclose identity of that other man involved in surgery, which the surgeon of record has been refusing and fighting so badly not to disclose. That's what it is about.

Dr. Cox,
thank you for your reply. The issue is that there are some indications that it was done something illegal that does not have anything to do with the surgery performed. That's what patient and some people believe. By "something illegal" is not meant only if that other person was enough qualified or licenced, but rather what was done on patient and if it is done something along the surgery performed that does not have anything to do with the surgery (some kind of experiment). As there are some evidence and indications suggesting that, for that matter, it would be very important to disclose identity of that other man involved in surgery, which the surgeon of record has been refusing and fighting so badly not to disclose. That's what it is about.

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Makes more sense. At any rate, I am still not sure the surgeon of record has to divulge the other's name legally, although ethically it would be the appropriate thing to do. Hope his malpractice insurance is paid up.

10+ Year Member

A surgical case was performed.
There was an unknown "physician" in the surgical one; one of whom no official record exists/record is being supressed and hidden by surgeon of record.
There is suspicion that this unknown individual either had shady credentials or a shady motive for being a part of this procedure.
Surgeon of records finds it in his or her best interests to keep the identity of this individual under wraps.
Patient/staff/patient's family suspect that something illegal and unscrupulous occurred during the procedure that was not normally justifiable or founded by the standards of science and surgical technique and theory.

So with that understood, it would appear that perhaps Nick and others involved suspect that this surgeon brought in someone who normally had little or no business being in the OR, and that person then proceeded to perform illegal procedures upon the patient.

Is there any evidence of wrongdoing in post-op, such as incision marks that shouldn't be there, or outcomes that cannot be explained by the nature of the procedure?

Can other members of the surgical team (RNs, Anesthesia, Scrub Techs, etc.) testify to an unusual involvement of this individual in the procedure?

Is the patient and the patients' advocates, as well as staff, pursuing a formal inquiry into this case through the courts?

As others have mentioned, I too find it odd that someone was able to get into an OR without anyone inquiring as to their identity. I mean, there would HAVE to be cameras that caught this person entering the hospital, unless they were already fully gowned upon arrival. I suppose it's not completely inconceivable that a lead surgeon would not be able to bring someone into the OR with them, but as the surgeon of record, all responsibility as well as outcomes lie on that surgeon. But if ethics can truly be solidly questioned, I do believe that the courts can subpoena the surgical records, and the surgeon if need be, to determine the identity of this "mystery physician".

7+ Year Member

Dimoak,
you understand the case the best so far. It is not that some person can come and do something on patient without being noticed. It is the case that the surgeon of record brought him and then did everything possible to hide his identity.

7+ Year Member

As others have mentioned, I too find it odd that someone was able to get into an OR without anyone inquiring as to their identity. .

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It is defintley possible. I did it earlier this week. I mean I was asked eventually (when I entered the surgery and stood around or a few minutes...but I was just standing there). Someone held the door open for me. I walked into the physician locker room, put scrubs on, mask, all that stuff and just walked by all the nurses. I even had one nurse ask if I was the new surgeon after I walked out to get something. (I am 21)......in a major hospital it probably doesn't happen but in a smaller community setting with much more trust that stuff like that wouldn't happen...could be possible although improbable. No real information to offer to the convo besides that though..sorry.

"Sadly, there are no integers on this scale, so your gangly adolescent attempt to be clever has proved futile."

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5+ Year Member

It is defintley possible. I did it earlier this week. I mean I was asked eventually (when I entered the surgery and stood around or a few minutes...but I was just standing there). Someone held the door open for me. I walked into the physician locker room, put scrubs on, mask, all that stuff and just walked by all the nurses. I even had one nurse ask if I was the new surgeon after I walked out to get something. (I am 21)......in a major hospital it probably doesn't happen but in a smaller community setting with much more trust that stuff like that wouldn't happen...could be possible although improbable. No real information to offer to the convo besides that though..sorry.

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So what you're saying is that in your experience you can't be in an OR for more than a few minutes without someone asking who you are and what you're doing there, even if you're not actually doing anything? Of course you can sneek into an OR if you're dressed properly. The point is that you'll be swiftly ejected if you have no business being there and if you are allowed to stay, your presence will be documented.

I'd be willing to bet that's the way it is even in the smallest community clinic in the armpit of nowhere.

Dimoak,
you understand the case the best so far. It is not that some person can come and do something on patient without being noticed. It is the case that the surgeon of record brought him and then did everything possible to hide his identity.

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I thought we all understood that this was what you were questioning, not just dimoak.

At any rate, in the past you've claimed to be an ENT resident but there are a number of parties who are suspicious (and not just in this thread) that you are a lawyer, seeking information for your case.

It all happened in private clinic. The surgeon is otolaringology specialist and he performed nose cosmetic surgery. The patient paid expensive surgery as cosmetic surgeries are not covered, of course. Surgeron brought someone and let do part of the surgery without patient's consent. Patient had very serious complications after and needed two more surgeries to fix the problem. The surgeon claimed that it was resident.
...
Can you please tell me if you think that my residency is in jeopardy now? Attending surgeon is about to reveal that it was me who was involved in the surgery. I was moonlighting in private clinic and all that bad things happened after. I think it can not be proved that it was my mistake.
...
I am at my last 4th year of ENT residency. When that thing happened I was at my first year. Now, at almost the end of my residency my residency is in jeopardy. And it is serious. Attending surgeon invited me to his private clinic as he was a good friend of mu father. He let me do part of the surgery and it went wrong. I did not have any experience at the time.
...
Well, the whole thing - nose moved away to one side. it was complicated to fix it and it nedeed two surgeries after.
The thing is that it was without patient's consent who actually paid the operation, no one is mentioned in any paper just like no one was there except the surgeon and regular staff. And we don't do any rotation at private clinics at all. That hurts the case immensely. Not to mention that cover up thing.

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Is all this accurate? You finished your chief year of an ENT residency last year, and are now being sued?

15+ Year Member

Blade,
why did you have to dig that thing? You make me feel embarrassed. What are you trying to prove? I already know that you are smart.

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Yeah, you have to be really smart to use the "search" function. Everything you post here is fair game and up for scrutiny. If you think you're that anonymous, why don't you tell us what really happened, instead of "a surgeon did this and another party did that..."

7+ Year Member

So what you're saying is that in your experience you can't be in an OR for more than a few minutes without someone asking who you are and what you're doing there, even if you're not actually doing anything? Of course you can sneek into an OR if you're dressed properly. The point is that you'll be swiftly ejected if you have no business being there and if you are allowed to stay, your presence will be documented.

I'd be willing to bet that's the way it is even in the smallest community clinic in the armpit of nowhere.

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I am saying I was standing by the door staring and doing nothing. If I actually assisted and acted like I knew what I was doing and the doctor knew me...who knows what could happen. Social engineering situations..if you even know a bit of the lingo you are assumed to be ok. At certain hospitals, with the crazy amounts of rent-a-docs they just have no clue who is suppossed to be there.....We had an anesthesiologist in one of the surgeries I observed that the nurses and doctors both asked who he was......

"Sadly, there are no integers on this scale, so your gangly adolescent attempt to be clever has proved futile."

Stop hovering to collapse...Click to collapse...Hover to expand...Click to expand...

Hardly. That is the character, Dr. John Cox, from the NBC series "Scrubs". There was some theory a few years ago (see the bottom of my posts) that the character was named after me. If it was, they owe me lots of money!

Looks nothing like me - I am female, with straight blonde hair and as a surgeon, would NEVER wear my stethoscope around my neck!

7+ Year Member

Hardly. That is the character, Dr. John Cox, from the NBC series "Scrubs". There was some theory a few years ago (see the bottom of my posts) that the character was named after me. If it was, they owe me lots of money!

Looks nothing like me - I am female, with straight blonde hair and as a surgeon, would NEVER wear my stethoscope around my neck!

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Wow. I was wondering how come "he" has name Kimberli which is more woman's name. So, I was kind of on right road.

Hardly. That is the character, Dr. John Cox, from the NBC series "Scrubs". There was some theory a few years ago (see the bottom of my posts) that the character was named after me. If it was, they owe me lots of money!

Looks nothing like me - I am female, with straight blonde hair and as a surgeon, would NEVER wear my stethoscope around my neck!

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Think that's Dr. Perry Cox, not John Cox.

And I agree - no surgeon would be caught dead with a stethoscope around their neck! Often when rounding wearing only scrubs, I don't even carry one - have to borrow one from the nurses or RTs during codes, for example!

And I agree - no surgeon would be caught dead with a stethoscope around their neck! Often when rounding wearing only scrubs, I don't even carry one - have to borrow one from the nurses or RTs during codes, for example!

7+ Year Member

Post the entirety of your question LUCIDLY or get the hell off of this forum. Your crap is pissing me off. I think Kim Cox/Blade28/SLUser would agree that this is getting stupid. How the hell can you be a senior surgery resident with this sort of communication skill? If you want advice about a specific issue, then post it, but folks shouldn't have to dig through archives to help you with your issues.

From what I gather, your surgeon acquaintance doesn't HAVE to say jack until he's ordered to by someone dangling a carrot in front of him (i.e. his license). Is he wrong? Maybe. Does he look suspicious? Yes. Those are the only conclusions that I can draw from your story so far.

Jayman, M.D.

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5+ Year Member

Post the entirety of your question LUCIDLY or get the hell off of this forum. Your crap is pissing me off. I think Kim Cox/Blade28/SLUser would agree that this is getting stupid. How the hell can you be a senior surgery resident with this sort of communication skill? If you want advice about a specific issue, then post it, but folks shouldn't have to dig through archives to help you with your issues.

From what I gather, your surgeon acquaintance doesn't HAVE to say jack until he's ordered to by someone dangling a carrot in front of him (i.e. his license). Is he wrong? Maybe. Does he look suspicious? Yes. Those are the only conclusions that I can draw from your story so far.

10+ Year Member

I am saying I was standing by the door staring and doing nothing. If I actually assisted and acted like I knew what I was doing and the doctor knew me...who knows what could happen. Social engineering situations..if you even know a bit of the lingo you are assumed to be ok. At certain hospitals, with the crazy amounts of rent-a-docs they just have no clue who is suppossed to be there.....We had an anesthesiologist in one of the surgeries I observed that the nurses and doctors both asked who he was......

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I don't know if something like that would be particularly wise. I assume that since you were there, they were already aware that you were observing or going to be there. I'm no expert, but I believe that the OR staff are usually aware whenever anyone who's normally not there will be around, and so will usually not hound you. However, I sincerely doubt that you'd be able to simply waltz into an OR and grab some cuttlery without anyone realizing that you wouldn't belong there. Even completely gowned up, the surgeon(s) and their staff would know you weren't supposed to be there (if they didn't, that hospital could face some MAJOR MAJOR legal repercussions for allowing someone who's not staffed and covered under malpractice insurance to get close to a pt in an OR), and you could face some nasty trespassing consequences.

To Nick: I do agree with many of the others that your posts do border on trolling, as you provide virtually no details of what you're discussing, and your grammar suggests that you're either not a native speaker of English, or atleast pretend not to be one. But giving you the benefit of the doubt and assuming your story is honest, I'm not an expert or authority on such matters, but I do not believe that you can be held accountable for mistakes you made during residency to such an extent, unless the attending surgeon claims that you were willingly negligent; such as stabbing the attending with a succinylcholine syringe and forcing him or her to watch helplessly as you slashed away at the patient, or purposefully ignoring the attendings' instructions in favor of cowboying, which ultimately went awry. In the majority of cases, I still think that accountability for an outcome is usually with the attending surgeon(s) or the surgeon of record, and that will usually include procedures that they allowed a resident to perform. If a surgeon truly believes that you acted recklessly or displayed a gross misconduct or inexcusable incompetence (probably fairly rare to occur just in one case), they would likely have asked you to leave the program. If that didn't happen, and you actually endedup successfully completing your residency, I really don't at the moment see how they could pin anything too serious on you from the details provided so far.

10+ Year Member

I can't believe I got sucked into this thread. damnit!
The curiosity was just too much to handle after days of seeing this thread hovering around the top of the list. Now it's like watching a train wreck.

15+ Year Member

Post the entirety of your question LUCIDLY or get the hell off of this forum. Your crap is pissing me off. I think Kim Cox/Blade28/SLUser would agree that this is getting stupid. How the hell can you be a senior surgery resident with this sort of communication skill? If you want advice about a specific issue, then post it, but folks shouldn't have to dig through archives to help you with your issues.

From what I gather, your surgeon acquaintance doesn't HAVE to say jack until he's ordered to by someone dangling a carrot in front of him (i.e. his license). Is he wrong? Maybe. Does he look suspicious? Yes. Those are the only conclusions that I can draw from your story so far.

In an earlier thread, Nick had asked if my Avatar was a picture of me. I responded that it wasn't but rather the actor "John Cox" from Scrubs. The guy's name is actually Perry Cox, and I wasn't sure where I got the name John Cox from (other than a deceased cousin of mine).

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